| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
133 |
119 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
36 |
33 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
30 |
$889.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
26 |
$858.22 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
28 |
$260.48 |
| 87807 |
|
13 |
13 |
$143.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
13 |
$133.28 |
| 2001F |
|
73 |
72 |
$0.00 |
| 97802 |
|
32 |
32 |
$0.00 |
| 1160F |
|
77 |
69 |
$0.00 |